The head of Texas Medical Center is concentrating on building out five institutes focused on areas of collaboration in innovation, health policy, clinical research, regenerative medicine, and genomics.
Since coming to Texas Medical Center from Stanford in 2012, Robert C. Robbins, MD, has staked his leadership on collaboration among the 56 independent member institutions in the Houston complex of healthcare facilities.
TMC faces challenges to collaboration, given that members also compete against each other fiercely in the Houston market, says Robbins, a renowned cardiac surgeon.
Robbins' top priority is harnessing the combined capabilities of all members. He's concentrating on building out five institutes focused on areas of collaboration—innovation, health policy, clinical research, regenerative medicine, and genomics.
Robbins spoke with HealthLeaders Media about his vision for TMC, how he plans to reach his collaboration goals, and his role in the process. The following conversation has been lightly edited.
HLM: TMC is governed by many independent institutions. How do you lead an organization like that?
Robbins: Most people don't understand how it works, and there's no good analog or comparable institution.
It's stated in the TMC bylaws is that if you accept the land, you must collaborate with the other institutions around the concept of improving the health of Houstonians, Texans, Americans, and the world. We're returning to that.
To use a sports analogy, the leaders from all the member institutions were asking for a general manager so they could focus on the coaching of their own institutions, and they were asking for a guy like me who could help lead them in the areas where they can work together.
HLM: Cross-institutional collaboration is one of your favorite initiatives. What forms does that take at TMC?
Robbins: I was brought in to focus on programmatic infrastructure. With all this activity, what we've lacked was translating fundamental discoveries into new drugs, devices and digital platforms.
The most important development at the medical center is our transitional research campus that we call TMC3, which consists of research buildings with an iconic double helix design, featuring cutting-edge research on imaging, genomic sequencing, and bioinformatics, among other initiatives.
The campus will have a hotel conference center and enough space so companies like IBM, Google, Johnson & Johnson, Medtronic, Amgen, and GlaxoSmithKline will build buildings beside our researchers and co-develop new drugs and devices.
HLM: How will TMC help move healthcare toward greater focus on value and safety?
Robbins: We've got the largest clinical operation of any site in the world, and we've got diversity not only in people but also in the type of institutions that make up our membership.
Hospital ERs a Mental Health Dumping Ground
MD Anderson is totally focused on cancer, Texas Heart Institute is focused on the heart, LBJ (Harris Health System) is focused on safety net hospitals, and Memorial Hermann has the busiest trauma center [in the U.S.]. One thing they all collaborate on is patient safety and quality.
Memorial Hermann got way out in front with ACO initiatives—they created one of the first of those—and it's the largest single health system in the country that's located only in one city. They realized the game was going to change.
We host Bob Kaplan and Michael Porter in teaching their Executive Education Course on value here at TMC every spring. A lot of sharing goes on there.
HLM: How can organizations historically focused on acute care remain relevant as healthcare moves from acute-care-focused to the so-called nonacute realm?
Robbins: All are realizing that managing readmissions and chronic disease patients, even mental health patients, is critical. We'll double the size of the dedicated academic medical center psychiatric facilities in the next two years.
We've got this project with Apple and one of our startups [that] leverages technology to pull all our data together so we can learn from each other.
It will take our 10 million yearly patient encounters from EMRs and add genomic data, prescription, and buying data, as well as other patient data from wearables—and soon implantables. You get to a point where you realize we can manage these patients at home in many cases and don't need to [treat] them all [on an inpatient basis].
HLM: How should healthcare organizations make sure they're credited for the value they create?
Robbins: Nobody is going to pay for value unless you go at risk for it. No one will pay you for hitting benchmarks on mortality or heart surgery, but they will put in disincentives (penalties). To truly provide quality, you have to be at risk for the patient, and healthcare spending has to be capitated.
The opportunities are vast for healthcare providers to incorporate genetic medicine into their offerings, but so, too, are the challenges. Join the upcoming HealthLeaders Media webcast, Getting Involved in Genetic Medicine with Cleveland Clinic, on February 27 and learn how Cleveland Clinic addresses the logistical, medical, and ethical complexities of this expanding field.
Philip Betbeze is the senior leadership editor at HealthLeaders.